Now that you’ve applied to your away rotations, let’s chat about what you can do to really stand out and be a great sub-intern. The two most important things you can do are to be prepared and be OBSERVANT. Your’e going to be thrust into new situations like 20 times a day. If you can be observant, look for patterns/ways to be helpful and then integrate yourself into the busy team structure, you’ll definitely stand out!
Check out this page for more information on applying to away rotations/VSLO.
Check out this page for more advice tailored for a surgical sub-internship.
Generally, students spend $2k to $5k on each away rotation (including flights/transportation, housing, and food costs)
Try to find ways to save money!
Live with friends/family to save on costs
Housing closer to your clinical assignment so you can save money on daily travel
Some programs will offer meal credits, so make use of them at the hospital
See housing/transportation tab below for more ideas
Try to put some money aside for fun activities to see the city and get to know the community
Contact the financial aid office (mayofinaid@mayo.edu) if you need help making a personalized financial plan for fourth year.
Generally the most expensive part of an away rotation is housing :(
You want to ensure you’ve confirmed safe+secure housing so that you don’t have to worry about that after a long day at the hospital
Housing closer to the hospital can be more expensive, but that means you may be able to save on daily transportation costs by walking/using public transport
Use your network! Reach out to friends/family for free housing (and maybe food)!
Ask past rotators/residents for housing recommendations
Might be able to connect you with where they stayed/what they recommend
Check out our student bios in order to contact MCASOM AZ alumni
Check out airbnb/vrbo for temporary housing
Check out rotatingroom.com
Need to make an account and upload proof of being a medical student, so set aside time to get this done earlier rather than later
Ask past rotators/residents if it’s helpful or difficult to rent a car
Might be annoying to figure out parking in a more urban hospital setting
Might be necessary if you’re required to be at multiple sites around the city
Consider renting a car through turo or other budget rental companies
4-5 pairs of scrubs
3 clinic outfits (business to business casual)
At least one formal suit/professional look
Sneakers (or clogs) for the hospital
Flat shoes
White coat (if you have one)
Jacket for the hospital
Work out clothes
Pajamas
Normal clothes to see the city, hangout, attend program social events
Laptop, phone, chargers, etc.
Battery pack (optional)
Fanny pack (optional)
Backpack
Toiletries (toothbrush, toothpaste, soap, shampoo, conditioner, SPF, etc.)
Generally, Mon-Sat from 6 AM to 6 PM
One day off a week
6-6 is the official shift, you may be required to come in earlier to pre-round
Generally, outpatient clinic days are shorter, but you still may have patients on the floor to take care of.
Some programs may expect you to do a few overnight shifts. They may or may not offer a post-call day, so just be prepared.
Have a 30 second patient presentation ready
Who’s the patient, what's the problem, why are you telling me about this person
Presentation, exam, plan
You will be asked f/u questions, that’s when you can fill in the details
follow the lead of your residents, they've been with the team longer and know what's pertinent.
In the morning: pre-round!
Get numbers (vitals, ins/outs, and labs), what happened yesterday/overnight (check images, talk to nurses, check nursing and consultant notes), and come up with a tentative plan for the day
Extra points if you keep a disposition plan in mind.
Help your residents out by keeping the hospital course updated
Grab gloves as soon as you go into a patient's room. You can’t be the first to help unless you’re gloved up.
Try to have the necessary tools handy such as your stethoscope, pen light, neuro tools, etc.
Watch the intern- see what they help with, figure out what you can do to help them do their job
Perfect your note-writing skills
Always ask for feedback! Great way to improve your skills and to show the team that you care and are engaged.
How to Write a Hospital Course
The hospital course is usually written in paragraph format to tell the story of what went on during a patient's admission. Keeping the hospital course up-to-date will help out your residents a :OT when it comes time to discharge patients. To write a good course, be organized, accurate, and concise. Use objective data like vital signs, lab results, and other objective findings. Document all relevant information and discussions, and review and edit before finalizing the course.
Timeline of Events: Chronologically document the patient's stay, including treatments, interventions, and complications.
Response to Treatment: Describe the patient's response to each treatment and any changes in their condition.
Consultations: Note any consultations with other specialists.
Discharge Plan: Outline the plan for the patient's care after discharge, including medications, follow-up appointments, and any necessary referrals.
Dispo Plan: Things to Consider
Dispo planning begins on admission! You should know where patient lives, who they live with, what kind of facility they live in, their support system, their ambulatory/functional status (ADLs/IADLs), do they have a home health aide, home medications, etc. Here are some questions you can ask yourself when planning a patient's discharge:
Do they look sick?
If yes, they are not ready for discharge!
Where do they live? Where are they able to safely discharge to and with whom?
Are they still on any IV medications? Can we transition to PO or do we need to arrange for home health?
Are we re-starting home meds? Any changes to home prescriptions? Any refills required?
Which pharmacy is most convenient? This can often be the hospital pharmacy.
Are they eating PO?
Have they had a bowel movement?
Can they urinate independently? Or are they going home with a catheter?
Do they have outpatient follow-up scheduled? Do they have a PCP?
PT/OT consult
evaluate for SNF?
Social Work/Case Management consult?
Do they have a ride? When will their ride be here to pick them up? Usually discharges aren't complete until noon.
Can we arrange a ride if they don't have someone who can transport them? Get SW/CM involved?
How to Write a Discharge Summary:
A discharge summary, also known as a discharge note, is a crucial document that summarizes a patient's hospital stay, including the reason for admission, diagnostic findings, treatment provided, and the patient's condition upon discharge. A well-written discharge summary ensures continuity of care, serves as a legal record, and facilitates accurate billing and reimbursement. It should include:
Diagnosis
Past Medical History
Medication(s) and Allergies
Procedures and Significant Tests
Reason for Admission and Hospital Course
Outstanding Issues
Follow Up Plan
Check out this PDF for a more in-depth explanation of each point or this link for a step-by-step guide.
Before you start your rotation:
Know the differential diagnoses for common complaints
Can’t miss diagnoses
Common clinical decision rules
Common treatments
Presentation skills
Ask yourself:
What interests me the most?
Where am I deficient or less strong?
During the Rotation:
Be on time
Be enthusiastic
Be prepared
Never lie
Own your patients
Ask questions
Interact with your team
Adhere with administrative requirements
Be humble
Have some fun!
Exercise, sleep, rest
Do something “local-ish” - great thing to ask residents/attendings!
Meet with faculty & residents
Interview with us
Request a Departmental SLOE
Interviews
Rotation serves as an interview, some institutions may offer a built-in interview at the end of the rotation OR you may be invited back for a formal interview
Most sub-i's will offer committee LoR
Usually not as strong as someone who actually knows you but programs may expect at least one LoR from a sub-internship rotation
If you end up working closely and often with one attending, that would be an appropriate person to ask for a letter. If you’ve worked with someone for 2 days, that probably won’t be a strong letter.
written February 2025 by Isra Abdulwadood